Percutaneous transvascular treatment of giant carotid aneurysms. Neuro-ophthalmologic findings

Kupersmith,; Berenstein,; Choi, Hyung-Wook; Ransohoff,; Flamm,

doi:10.1016/0002-9394(84)90229-0

Cited by 3 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The presence of bilateral cavernous aneurysms and intracranial aneurysms in other sites, not seen in this report, suggest that a degenerative process secondary to a genetic factor of fragility in the vascular wall should be present 2,3,8,9,10,13 .…”

Section: Casesmentioning

confidence: 58%

“…Rarely do CCAs suffer rupture with and subarachnoid hemorrhage by the time of diagnostic, due to the fact that cavernous sinus are composed by dural slices, which lay over the body of sphenoid and are, infrequently, projected towards the subarachnoid space 2,8 . We show one case of bone erosion (20%), without rupture or epistaxis.…”

Section: Casesmentioning

confidence: 99%

“…This symptom follows VIth cranial nerve lesions due to its position within cavernous sinus, as shown in Fig 1 2,7 . The association with other nerves (IIIrd, IVth, V1 and V2), located in the lateral wall of cavernous sinus characterizes the complete cavernous sinus syndrome 6,8,13,28 .…”

Section: Casesmentioning

confidence: 99%

“…CCAs can arise from any segment of cavernous carotid artery (Fig 1), but most commonly are originated in the horizontal segment, being projected forwardly and laterally, with the superior orbitary fissure and below the anterior clinoid process 3 . CCA morbidity and mortality indices are low [4][5][6][7] , however, pain and neuro-ophthalmologic deficits due to neurovascular compression are frequent, what highlights the possibility of surgical treatment 7,8 . The vast majority of intracranial intradural aneurysms can be micro-surgically treated, commonly through aneurysmatic isolation without vascular occlusion, while CCA, when operated, frequently are through occlusion of ipsilateral ICA, with cerebral ischemia and amaurosis risks [9][10][11] .…”

mentioning

confidence: 99%

See 3 more Smart Citations

Spontaneous thrombosis of internal carotid artery: a natural history of giant carotid cavernous aneurysms

Vasconcellos¹,

Flores²,

Conti³

et al. 2009

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

-Objective: To describe five cases of giant carotid cavernous aneurysms which evolved with spontaneous thrombosis of internal carotid artery (STICA), with emphasis at epidemiology, clinical presentation, natural history, related factors and neurological outcome. Method: There were 711 consecutives patients with 802 aneurysms with and without surgical treatment during a period of 19 years. We selected 35 patients with 40 carotid cavernous aneurysms (5%) of which 20 (50%) were giant aneurysms. Among those cases, 5 patients evolved with STICA (25%). Symptoms and findings at presentation were recorded and compared with those at outcome. Results: Clinical presentation was commonly related to atherosclerotic factors such as elevated blood pressure (80%), diabetes mellitus (40%) and dislipidemy (40%). All patients presented with hemicranial headache, ophthalmparesy and retro bulbar pain, and after STICA all presented improvement of symptoms. After STICA, 4 patients had regression of deficit, 2 partial and 2 complete. Four patients had sensorial trigeminal neuropathy in V1 and V2 territories, also showing improvement of symptoms after STICA. Conclusion: STICA is a common outcome in giant carotid cavernous aneurysms, and is related with significant improvement of symptoms; however, it may be catastrophic for those patients without efficient collateral circulation.KEY WORDS: carotid cavernous aneurysms, carotid thrombosis, atherosclerosis.trombose espontânea da artéria carótida interna: a história natural dos aneurismas gigantes intracavernosos resumo -Objetivo: Relatar cinco casos de aneurismas gigantes intracavernosos que evoluíram com trombose espontânea da artéria carótida interna (TEACI), estudando-se: prevalência, apresentação clínica, história natural, fatores associados e prognóstico neurológico. Método: Análise de 711 pacientes consecutivos com diagnóstico de 802 aneurismas cerebrais submetidos a tratamento clínico ou cirúrgico num período de 19 anos. Foram identificados 40 aneurismas intracavernosos, sendo que 20 desses eram gigantes. Dentre esses, 5 pacientes com aneurismas gigantes intracavernosos que evoluíram com TEACI (25%). Os sintomas e sinais neurológicos da apresentação foram registrados e comparados ao término do acompanhamento. Resultados: Todos pacientes apresentavam cefaléia hemicraniana, apresentavam oftalmoplegia e dor retro-orbitária. Freqüentemente estavam associados a fatores ateroscleróticos como HAS (80%), diabetes melito (40%) e dislipidemia (40%) e após a TEACI evoluíram com melhora desses sintomas. Após a TEACI, 4 pacientes tiveram regressão do déficit, sendo que em 2 a regressão do déficit foi total. Quatro pacientes apresentavam hipostesia no território de V1 e V2. Todos apresentaram melhora desse sintoma. Conclusão: A TEACI é uma evolução comum em aneurismas intracavernosos gigantes, e está associada à melhora importante dos sintomas. No entanto pode ser catastrófica naqueles pacientes sem circulação colateral eficiente. PALAVRAS-CHAVE: aneurisma intracavernoso, trombose carotí...

show abstract

Section: Casesmentioning

confidence: 58%

Section: Casesmentioning

confidence: 99%

Section: Casesmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Spontaneous thrombosis of internal carotid artery: a natural history of giant carotid cavernous aneurysms

Vasconcellos¹,

Flores²,

Conti³

et al. 2009

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…other aneurysmatic sites within the intracavernous segment are also common, what can interrogate the existence of other pathogenic mechanisms as atherosclerosis and dissection, spontaneous or traumatic 6 . ccA morbidity and mortality indices are low [7][8][9][10] , however, pain and neuro-ophthalmologic deficits due to neurovascular compression are frequent, what highlights the possibility of surgical treatment 6,11 . The vast majority of intracranial intradural aneurysms can be micro-surgically carotid cavernous aneurysms vasconcellos et al…”

mentioning

confidence: 99%

Presentation and treatment of carotid cavernous aneurysms

Vasconcellos

Flores

Veiga

et al. 2008

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

-We analyzed a group of patients with the diagnosis of internal carotid aneurysms in its intracavernous segment, with emphasis in prevalence, clinical features, treatments, evolution and neurological prognosis. Neurological signs and symptoms at initial presentation were registered and compared with final outcome. Patients were divided into two stratified groups, one with 19 patients which underwent interventionist treatment, and another with 21 patients who were conservatively treated. The present study demonstrated that intervention is significantly correlated with a better prognosis considering evolution of pain symptoms secondary to neurovascular compression (p=0,002). Regarding neurological deficits, an interventionist approach was also significantly correlated with better outcome in comparison with initial presentation (p=0,008). These results indicate that interventionist treatment determines improvement or resolution of pain symptoms in comparison with patients conservatively treated, as well as stabilization or partial improvement of neuroophthalmological deficits.Key WoRds: carotid cavernous aneurysm, clinical treatment, interventionist treatment, prognosis. apresentação e tratamento dos aneurismas intracavernososResumo -Analisamos um grupo de pacientes com diagnóstico de aneurismas da artéria carótida interna, em sua porção intracavernosa, estudando-se: prevalência, apresentação clínica, formas de tratamento, evolução e prognóstico neurológico. os sintomas e sinais neurológicos da apresentação foram registrados e comparados ao término do acompanhamento, com um grupo de 21 aneurismas submetidos a tratamento conservador e outro com 19 a tratamento intervencionista. o estudo demonstrou que a intervenção está relacionada a um melhor prognóstico, quanto à evolução do quadro álgico secundário à compressão neurovascular (p=0,002). em relação ao déficit neurológico, a abordagem intervencionista pôde ser associada com uma melhora do quadro inicial (p=0,008). estes resultados indicam que o tratamento intervencionista proporcionou melhora ou resolução do sintoma dor em comparação ao grupo de pacientes com tratamento conservador, além de levar a uma estabilização ou melhora parcial dos déficits neuro-oftalmológicos.

show abstract

Terapi Endovaskular Aneurisma Karotis Kavernosa Dengan Pipeline Flex Embolization Device: Pengamatan 1 Tahun

Amran

Ban²,

Bahar³

et al. 2020

View full text Add to dashboard Cite

ENDOVASCULAR TREATMENT CAVERNOUS CAROTID ANEURYSM WITH PIPELINE FLEX EMBOLIZATION DEVICE: 1-YEAR FOLLOW UPABSTRACTAsymptomatic intracranial aneurysms are usually detected accidentally through neuroimaging. However, a large intracranial aneurysm (15-24mm) is more likely to manifest clinically due to its mass effect. Aneurysms in the cavernous segment of carotid artery generally exhibit occulomotor nerve palsy, headache and dizziness. The selection of endovascular therapy depends on the type and morphology of the aneurysm. Currently, the treatment options were stent-assisted coil and pipeline embolization device (PED). We reported two cases of large symptomatic unruptured cavernous carotid aneurysm (CCA), treated with the flow diverter technique using a pipeline flex embolization device (PED flex) the second generation of PED. The first case was a 59-year-old woman with complaint of diplopia and headache. Computed Tomography (CT) angiography and 3 dimensional (D) brain imaging revealed bilateral aneurysms, one was in the right cavernous carotid (16.1x16.6mm) and the other was in the left cavernous carotid (9.2x6.5mm). In second case a 67-year-old woman with complaint of headache. Magnetic resonance angiography (MRA) revealed a 15mm aneurysm in the right cavernous carotid. Both aneurysms were treated using PED flex (4.75mm diameter/25mm length and 4mm diameter/25mm length, respectively), except the left cavernous carotid aneurysm in the first case. Six month and one year follow up angiograms were obtained, and showed complete occlusion of aneurysms. Flow diverter technique using PED flex is a feasible and effective treatment for large symptomatic unruptured carotid cavernous aneurysms.Keywords: Embolization, flow-diverter, large cavernous carotid aneurysms, pipeline flex embolization device (PED flex)ABSTRAKAneurisma intrakranial asimptomatik biasanya terdeteksi secara tidak sengaja melalui pemeriksaan pencitraan neuroradiologis. Akan tetapi aneurisma intrakranial yang besar (15-24mm) cenderung memberikan gejala klinis akibat efek massa yang ditimbulkan. Apabila aneurisma terletak di arteri karotis segmen kavernosa, penderita dapat mengalami paresis nervus okulomotor dan juga terkadang memberikan gejala nyeri kepala serta rasa pusing. Pemilihan terapi endovaskuler bergantung pada tipe dan morfologi dari aneurisma. Saat ini, pemilihan terapi endovaskuler dapat berupa stent-assisted coiling dan alat embolisasi pipeline. Kami melaporkan dua kasus aneurisma karotis kavernosa (AKK) tidak pecah berukuran besar simptomatik dengan teknik flow-diverter menggunakan pipeline flex embolization device (PED flex) yang merupakan generasi kedua dari alat embolisasi pipeline. Pada kasus pertama wanita 59 tahun dengan keluhan diplopia dan nyeri kepala, pemeriksaan Computed Tomography (CT) angiografi dan 3 dimensi (D) otak ditemukan aneurisma pada karotis kavernosa bilateral, yang masing-masing berukuran (16,1x16,6mm) pada sisi kanan dan (9,2x6,5mm) pada sisi kiri. Pada kasus kedua, wanita 67 tahun dengan keluhan nyeri kepala. Pemeriksaan MRA otak ditemukan aneurisma berukuran 15mm pada karotis kavernosa sebelah kanan. Masing-masing aneurisma diterapi dengan PED flex (4,75mm diameter/25mm panjang dan 4mm diameter/25mm panjang), kecuali aneurisma pada karotis kavernosa sebelah kiri pada kasus pertama. Follow-up pada enam bulan dan satu tahun kemudian, dengan pemeriksaan angiografi, menunjukkan oklusi komplet pada masing- masing aneurisma. Terapi endovaskular dengan teknik flow-diverter menggunakan PED flex merupakan modalitas terapi yang efektif dan dapat dilaksanakan untuk aneurisma karotis kavernosa berukuran besar bergejala.Kata kunci: Aneurisma karotis kavernosa besar, embolisasi, flow-diverter, pipeline flex embolization device (PED flex)

show abstract

Percutaneous transvascular treatment of giant carotid aneurysms. Neuro-ophthalmologic findings

Cited by 3 publications

References 0 publications

Spontaneous thrombosis of internal carotid artery: a natural history of giant carotid cavernous aneurysms

Spontaneous thrombosis of internal carotid artery: a natural history of giant carotid cavernous aneurysms

Presentation and treatment of carotid cavernous aneurysms

Terapi Endovaskular Aneurisma Karotis Kavernosa Dengan Pipeline Flex Embolization Device: Pengamatan 1 Tahun

Contact Info

Product

Resources

About